Thursday, March 26, 2015

A civil rights activist in South Carolina had the most practical reaction
I’ve seen about the controversy over Sons of Confederate Veterans’ specialty license
plates.

The Rev. Joseph Darby, first vice president of the Charleston NAACP,
said he is not opposed to plates with a Confederate battle flag because they
identify people of whom he should be wary, reported Diane Knich of The Post and
Courier newspaper.

“I don’t turn my back on that person because you never know,” Darby
said.

South Carolina is one of nine states that produce Sons of
Confederate Veterans’ license plates featuring the battle flag. Others are
Alabama, Georgia, Louisiana, Maryland, Mississippi, North Carolina, Tennessee
and Virginia.

The Supreme Court heard oral arguments Monday in Walker v. Texas Division, Sons of Confederate Veterans, a case involving
Texas’ denial of the Sons’ specialty plate on grounds it “might be offensive to
any member of the public.”

The Sons say the flag celebrates Southern heritage, but for many
African Americans it is a potent symbol of oppression and racism. If someone chooses
to exercise his right to free speech by paying extra for a license plate he
knows others find offensive, he is, as
Darby suggests, giving the rest of us fair warning. You never know.

We’ve always judged motorists by their bumper strips and decals. Now
state governments have discovered a dandy fund-raising machine that offers our
vehicle as a means of self-expression. For a fee, each motorist can have a unique
soapbox, the 6-inch by 12-inch rectangle of aluminum on our bumpers.

Texas offers more than 400 specialty plates, touting enthusiasms, groups
and causes, any number of which might be offensive to someone. But it has
denied only a couple of applications.

The Lone Star State embraces its Confederate heritage with Confederate
Heroes Day, an official state holiday on Jan. 19. Three permanent monuments to
Confederate soldiers are on the state Capitol grounds. The Capitol gift shop
sells Confederate battle flag posters, fake Confederate money and miniature Confederate
flags. A nearby state office building is named for the postmaster general of
the Confederate States of America.

But when the Sons applied for a plate with its logo, the
Confederate battle flag surrounded by the words “Sons of Confederate Veterans
1896,” with a faint Confederate flag in the background, thousands of complaints
poured into the board of motor vehicles, which rejected the request.

At issue for the Supreme Court is whether specialty plates are
private speech protected by the First Amendment or government speech and
subject to censorship. Texas argues that the government makes and owns the
plates and has the right to restrict what they say. The Sons say the plates are
private, protected speech.

More than speech issues are involved, though. License plates are
big business. Texas raked in $17.6 million last year from specialty plates.

“They’re only doing this to get the money,” Chief Justice John
Roberts said during oral arguments.

States typically pass some of the fee back to the nonprofit
organizations. For example, Choose Life America raised more than $21 million from
August 2000 through last October from specialty plate sales in 29 states and
the District of Columbia, according to court documents.

The court has delayed consideration
of a separate case from North Carolina, Berger
v. American Civil Liberties Union of
North Carolina. The state legislature approved the anti-abortion “Choose
Life” specialty plate but then denied a request for one with the abortion-rights
message, “Respect Choice.”

Texas argues that if it grants the Sons a specialty plate, it will
have to allow plates from even the most offensive groups, such as al-Qaida. Roberts
had an alternative solution.

“If you don’t want to have the al-Qaida license plate, don’t get
into the business of allowing people to buy…the space to put on whatever they
want to say,” the chief justice said.

The court is expected to rule in June. One solution, as Roberts
suggests, is for states to stop selling license plates as a soapbox. That’s sensible,
but states would hate to lose the easy revenue.

Most motorists, though, would be happy not to have to look at offensive
license plates.

Thursday, March 19, 2015

In March 1975, Sen. William Proxmire, Democrat of
Wisconsin, grabbed headlines when he bestowed his first Golden Fleece Award. His
target: “wasteful, ridiculous or ironic use of taxpayers’ money.”

Sound familiar? Some things haven’t changed in 40
years; politicians are still fighting what they deem ludicrous federal spending,
although few are as clever as Proxmire.

His first Fleece went to the National Science
Foundation for spending $84,000 to study why people fall in love.

“Not even the National Science Foundation can argue
that falling in love is a science,” Proxmire declared. Besides, he said, nobody really wants to know why people fall in love.

“I believe that 200 million other Americans want to
leave some things in life a mystery, and right on top of the things we don’t
want to know is why a man falls in love with a woman and vice versa,” he wrote,
adding that such questions are best left to Elizabeth Barrett Browning and
Irving Berlin.

A national debate erupted, with conservative Barry
Goldwater and three Nobel laureates coming to the researchers’ defense. Columnist
James Reston of The New York Times said that Proxmire, normally a sensible,
modern man who believed in government’s ability to help solve problems, must
have been kidding.

“If the sociologists and psychologists can get even
a suggestion of the answer to our pattern of romantic love, marriage,
disillusion, divorce – and the children left behind – it could be the best
investment of federal money since Mr. Jefferson made the Louisiana Purchase,”
Reston wrote.

Reston identified a clash of two worthy goals that continues
today: We want to eliminate stupid spending but we also want to support
research that could help solve society’s problems.

Proxmire wasn’t kidding. His second Fleece in April
1975 took on a University of Michigan researcher who had received $500,000 from
three federal agencies to study how and why rats, monkeys and humans clench
their jaws.

The researcher sued Proxmire for libel. The Supreme
Court found the senator was not immune from suit; he settled out of court for
$10,000 and apologized to the researcher on the Senate floor. Proxmire’s legal fees, totaling more than $124,000, were paid by
the Senate. The researcher paid his own legal bills.

Proxmire stopped naming researchers after that, but
he fired off 166 more press releases announcing Golden Fleece Awards before he
left the Senate in 1989.

Over the decades, members of both parties in
Congress have crusaded against what they see as wasteful spending. Sen. Dan
Coats, Republican of Indiana, last month started giving Waste of the Week
awards, recycling items from the Wastebook that former Sen. Tom Coburn,
Republican of Oklahoma, issued annually the last few years. Coburn retired last
year.

Coats gave his Waste award March 11 to the National
Institutes of Health for spending $387,000 on rabbit massage research at Ohio
State University.

“Does NIH need to fund a study to determine the
benefits of massage by using 18 white rabbits from New Zealand that receive
30-minute massages four times a day?” Coats asked on the Senate floor. He
quoted an official at Ohio State’s Sports Medical Center who said, “We tried to
mimic Swedish massage because anecdotally it’s the most popular technique used
by athletes.”

“Why didn’t they just ask the football team?” Coats
said.

Actually, even though athletes often use massage,
researchers say they don’t know the mechanism of how massage improves recovery
after exercise and injury. That’s where the
rabbits came in.

Ohio State defended its project as “important
research designed to help address a key question: Is massage effective as a
medical treatment?” The answer could help millions of people who suffer medical
conditions that affect their muscles, the university maintained.

One thing is clear. As much as politicians love to make
fun of research that sounds frivolous, they rarely act to stop wasteful
spending. If they wanted to stop the appearance of grandstanding, they could
rely on the annual recommendations of the nonpartisan Government Accountability
Office to reduce overlap and duplication in federal programs as well as
improper payments.

Congress and the executive branch implemented only
29 percent of GAO’s cost-saving recommendations over the last four years. The government-wide
recommendations reach far beyond funny-sounding research projects.

To curb waste in government, members of Congress can
dust off GAO’s reports and start implementing the recommendations. Ridicule may
be entertaining but it won’t eliminate government waste.

Thursday, March 12, 2015

You know about Hillary Clinton’s private emails and
about the infamous letter signed by 47 Senate Republicans aimed at torpedoing
an international deal on Iran’s nuclear program.

But did you know the federal government is about to
make many of us envy a fourth grader?

That’s one of the lesser news items you may have
missed the last few weeks as news outlets obsessed over weightier topics and scandals
du jour.

Here are three recent developments that won’t change
the fate of the world or even the 2016 presidential election but may – just may
-- improve Americans’ quality of life:

1) About those fourth graders: Starting this fall,
the federal government will give every fourth grader and their families a pass
for free admission to all of America’s national parks and public lands for a
full year.

“We want every fourth grader to have the experience
of getting out and discovering America. We want them to see the outside of a
classroom,” President Barack Obama said in Chicago last month when he announced
his “Every Kid in a Park” initiative.

“Put down that smart phone for a second. Put away
the video games. Breathe some fresh air,” the dad in chief counseled. A 2010 Kaiser Family Foundation study found
that young people devote an average of more than seven hours a day to
electronic media use, or about 53 hours a week, he said. That’s more than a
full time job.

Besides the addictive appeal of electronic devices,
there are practical reasons why kids don’t spend more time in nature. About 80
percent of families live in urban areas where it’s not easy to spend time
outdoors safely; many schools have dropped field trips to save money.

An annual pass to the nation’s parks and public
lands usually costs $80, and children under 16 are always free. Giving kids themselves
the passes, though, may help create a lifetime connection to nature. But first,
they have to get there.

Needy families will receive transportation grants to
visit parks, public lands and waters from the National Park Foundation, a
charitable organization that supports the National Park Service.

Research has found that early exposure to nature and
outdoor activities can influence attitudes in adulthood. Today’s young hiker
may be tomorrow’s steward of the environment. Or not.

Young screen fanatics who spend most of their time
indoors will grow up without any appreciation of nature. As adults, they won’t care
less about preserving undeveloped nature.

2) Which leads us to Secretary of Interior Sally
Jewell and her announcement Thursday of a $5 million grant over four years from
the American Express Foundation.

The goal: triple the number of volunteers in national
parks and public lands to one million volunteers annually by 2017.

Interior is working to engage the next generation of
ordinary citizens, mayors and state and federal officials in nature so
everybody understands and wants to preserve green space.

“We need
partners,” said Jewell, whose agency has responsibility for one in five acres
in the United States. “We can’t do it alone.”

American Eagle Outfitters donated $1 million last
year and began engaging other companies in the campaign.

“We won’t
have advocates for open spaces if people don’t value them,” Jewell said.

Among her plans is to
expand the 21st Century Conservation Service Corps, modeled on President
Franklin D. Roosevelt’s Civilian Conservation Corps, which puts the unemployed
and recent veterans to work.

3) Finally, a hopeful news alert: The cherry
blossoms are coming.

Blossom experts (yes, they are) predict the peak will
be April 11 to 14, a week or so later than usual because of the long, cold
winter. But even in politically-fractured

Washington, the blossoms are a sure
sign that spring is around the corner. Somewhere.

Dates for the Cherry Blossom Festival were set earlier.
The festival is slated to run from March 20 to April 12, which means the blossoms
once again may only partly coincide with the festivities.

For that miscalculation, you may blame Obama…Clinton…Republicans...but
it’s all a stretch.

Speaking of stretching…put down that phone, step
outside and breathe. We can’t all be fourth graders, but we all can get
outside. And that’s not an inconsequential goal in the digital age.

Thursday, March 5, 2015

One in 10 active physicians is between the ages of
65 and 75 – retirement age. More than a quarter is 55 to 64 -- likely to retire
within the decade.

The graying of our doctors and ourselves is part of the
larger problem of access to health care. The goal of the Affordable Care Act,
or Obamacare, is to help everyone get insurance. Then what?

If you have health insurance through your employer
or a public program such as Medicare, Medicaid or the Veterans Administration –
as nearly 85 percent of us do -- access depends on when you can see your doctor.
That can be days, weeks or even months.

Seeing a doctor likely will get only more difficult,
unless Congress acts. And even that won’t solve the problem.

By 2025, the nation will be short 46,000 to 90,000
physicians overall, the Association of American Medical Colleges warned Tuesday
in its latest study, “The Complexities of Physician Supply and Demand: Projections
from 2013 to 2025.”

The study,
which based its findings on demographic trends and changes in health care
delivery and payment policies, projected a shortage of 12,000 to 31,000 primary
care physicians and 28,000 to 63,000 specialists, notably surgeons of various
types.

“The doctor
shortage is real – it’s significant – and it’s particularly serious for the
kind of medical care that our aging population is going to need,” said Dr. Darrell
G. Kirch, the association’s president and CEO, in releasing the report. The
association represents 158 medical schools, 400 teaching hospitals and 51
Veterans Administration medical centers.

The physician shortage showed up last summer at VA
facilities with delays in care, Kirch told reporters. He noted that the over-65
population in the United States is projected to grow 46 percent by 2025.

Older, sicker people need more medical care, but physicians
already say they’re overworked. In a survey last year, 81 percent described
themselves as over-extended or at full capacity, and only 19 percent said they
had time to see more patients.

Forty-four percent planned to cut back on patients
seen, work part time, close their practices to new patients or retire, the 2014
Physicians Foundation nationwide survey found.

By the way, if you’re inclined to blame the influx
of newly insured people through Obamacare, don’t. Even though an estimated 26
million people eventually will have insurance or other health care coverage
through the law, those patients now are projected to increase the demand for
physician services by only 2 percent or 16,000 to 17,000 doctors, the medical
colleges’ report said.

Overall shortfall projections in the medical
colleges’ study are smaller than those in 2010, when its study estimated a
130,600-physician shortfall. The lower shortfall numbers reflect such changes
as more physicians completing their training and lower Census projections of
the population, the new report said.

Medical groups want Congress to raise the cap on the
number of medical residencies from about 29,000 a year to 32,000.That would
cost about $1 billion every year through 2025, Dr. Janis M. Orlowski, chief health
care officer of the medical colleges association, says. Medicare pays $40,000 of the $152,000 a year it costs to train a medical
resident.

The cap was set “temporarily” in 1997; attempts to
lift it have languished in Congress for years. Even if Congress does find $10
billion to boost the number of residents, though, other changes will be needed,
experts agree.

An Institute of Medicine report last July said that
the doc shortage is mostly geographical; many doctors train in New Jersey, New
York and Massachusetts – and stay there to practice. Plus, a reallocation
between primary care and specialist residency slots is needed.

A bright spot is the rapid growth in the number of
advanced practice nurses and nurse practitioners and their increased role in
delivering care. But, says the medical colleges’ report, “even in these
scenarios, physician shortages are projected to persist.”

Here’s a problem Republicans and Democrats in
Congress should tackle together – and soon. They’re not getting any younger
either.